|The major aim of this proposed research is to examine whether patient quality of life and length of survival is impacted by the CHESS-LC (Comprehensive Health Enhancement Support System - Lung Cancer) intervention. To accomplish this, we will conduct a longitudinal, randomized clinical trial comparing the CHESS-LC intervention to an Internet Control group. The primary aims and related hypotheses are:|
1) Determine the impact of CHESS-LC on patient quality of life. We hypothesize that at 6 and 12 months posttest, quality of life will be greater among CHESS-LC users compared to the control group.
2) Determine the impact of CHESS-LC on patient survival. Compared to a Usual Care Control, CHESS-LC patients will have greater median survival.
Self Determination Theory (SDT) provides a framework for the analysis of mechanisms by which CHESS-LC may have a positive impact on quality of life and survival. The secondary aims and hypotheses are:
1) Examine the effects of CHESS-LC use on the SDT constructs of competence, autonomy, and relatedness. We hypothesize that CHESS-LC will enhance autonomy, competence and relatedness.
2) Examine the factors that moderate the effect of CHESS-LC use on SDT constructs. We hypothesize that age, gender, education, stage of cancer, cancer treatment, and co-morbidities may moderate the effect of CHESS-LC use on competence, autonomy, and relatedness.
3) Test whether competence, autonomy and relatedness mediate the effects of CHESS-LC use on QOL as hypothesized.
4) Test whether treatment participation mediates the effect QOL has on survival as hypothesized.
5) Characterize the effects of patient-caregiver relationship quality (relatedness) on patient QOL over time and determine whether this association differs depending on the combined effects of gender (male vs. female) and social role (patient vs. caregiver).